When the United States Supreme Court
upheld the constitutionality of most of the Affordable Care Act last June it managed to alter the debate on ACA without ending opposition to it. In fact, as the increasing complexities of implementing ACA continue to surface more people from both the political Right and Left are raising their voices to advocate for other options.
has been providing inspiration, resources and a network to people who want to organize what they call Truth Hearings around the country. As explained on the Healthcare-NOW! website, “A Truth Hearing is an event that invites everyone in your community to hear testimonials from people who are experiencing the healthcare crisis first hand.” These events are open to Democrats, Republicans and everyone in-between who want to share their story and hear the stories of others.
One upcoming Truth Hearing in Huntsville, Alabama is being organized by pediatrician and educator, Dr. Pippa Abston. The Huntsville Truth Hearing will take place this coming Wednesday, July 31. I emailed Dr. Abston to learn more about the post-ACA state of healthcare in Alabama and to find out more about the upcoming event.
The Recollective: What prompted you to organize the Truth Hearing event?
Abston (right) at a recent demonstration in Alabama
Dr. Abston: I saw a description of similar events on the Healthcare-Now! website and thought it would be a great way to include more local people in the conversation about healthcare access.
The Recollective: Can you describe the purpose of the Truth Hearing event?
Dr. Abston: We want to bring diverse members of the community together to tell their personal stories about difficulty getting healthcare directly to each other and to elected leaders, without commentary or interpretation that could be perceived as biased. There are so many stereotypes and misconceptions about who has trouble getting needed care and why. We hope that the direct witnessing of stories will help undo some of the barriers to understanding each other. And we also believe that as the health insurance environment changes, we need to hear the truth about what happens directly from each other, face to face.
The Recollective: Why do you think personal stories are important to healthcare reform?
Dr. Abston: We all respond more deeply to a real person than we do to statistics. All those numbers are of course real, individual humans– but we need to see faces and hear voices to have the best understanding of each other.
The Recollective: Can you describe the healthcare issues that are facing the people of Huntsville?
Dr. Abston: Although we have a high population of educated and insured people workingwith Redstone Arsenal and the aerospace industry— in fact, the highest number of PhDs per capita in a US city– we also have far too many who lack even minimal health insurance coverage despite working at one or more minimum wage jobs. Because we area “right to work” state, we lack union influence to insist on insurance coverage for those workers. We rely heavily on low-wage labor from immigrant and migrant workers who too often lack insurance coverage, even if they have legal documentation. We don’t have enough primary care doctors to serve everyone here, and we have very restrictive regulations preventing other health professionals like nurse practitioners from filling the gaps– they cannot practice independently.
Recent event sponsored by North Alabama Healthcare for All
We have an increasing trend for doctors to go “concierge”— stop taking insurance and instead charge large annual or monthly fees, while they sharply reduce the number of patients they agree to care for. Many have stopped taking new Medicare patients, and not enough accept Medicaid, the insurance for more than 40% of our children. We have a large group of families with Tricare because of the Arsenal, and many physicians refuse to accept Tricare. Those with other private insurances are encountering increasingly steep co-pays and deductibles combined with denials of coverage for services they need. They have insurance cards they can’t afford to use. Many don’t realize their coverage is inadequate until they have a significant health need.
The Recollective: What has been state government’s response to ACA in Alabama?
Dr. Abston: Our Governor, a retired dermatologist, refused to select the insurance plan that will serve as a benchmark for “essential health benefits” on the Exchange, which caused our EHB to default to a plan with insufficient coverage. He has handed over the Exchange itself to the federal government, so that Alabama citizens have no input into design. And he has failed so far to accept the Medicaid Expansion.
The Recollective: How have healthcare advocates and professionals in Alabama responded to ACA and the ongoing debate about healthcare?
Dr. Abston: I have not seen large surveys tallying opinions here in the medical community, but what I encounter locally is a strong opposition to the ACA. There is a perception that healthcare is a commodity like any other and that physicians are losing control of their businesses. There are a few voices speaking up for the public, but really not that many. I am opposed to the ACA personally– I see it as a giant, complex shell game that does not ultimately improve access to health services and in fact will allow the private insurance industry to gain even more control than they have already. I am in favor of Medicare for All. Although I have difficulty convincing other physicians to advocate openly for this, I often get whispered support in the hallways of our local hospital.
The Recollective: What do you hope the Truth Hearing will accomplish?
Dr. Abston: I hope to break down barriers– I hope everyone who attends will have at least some small moment of epiphany. I hope we will hear the stories and realize “this could be me– or my parents, my sister or brother, my children.”
The Recollective: Who will be participating in the Truth Hearing?
Dr. Abston: The sponsor is North Alabama Healthcare for All, a chapter of Physicians for a National Health Program (PNHP). The public is being widely invited by flyers and social media. We hope to have a good cross-section of the community in attendance and are inviting press coverage. Our organization will not use this platform as an opportunity to discuss Medicare for All. We will have written information available and follow-up sessions. We believe that once people hear the stories and digest them, they may begin to see why we need healthcare that includes everyone fully.